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Obesity, Public Health, Diversity & Inclusion
Whole-population trends in obesity across dimensions of inequality in England, 2019-25: a retrospective, longitudinal cohort study of 54 million adults
Fletcher RA, Conrad N, Rockenschaub P, Logothetis SB, Neuen BL, Chalmers F, Dalakoti M, Raffetti E, Denaxas S, Khunti K, Farooqi IS, Arnott C, Di Angelantonio E, Danesh J, Sofat R, Sattar N, Wood AM
June 26, 2026 at 1:55:52 PM
Abstract
Obesity is one of the 21st century's greatest public health challenges. We analyzed whole-population electronic health records for adults aged 18-99 in England, estimating age- and sex-standardised incidence and prevalence rates of obesity from 2019 to 2025 by age, sex, socioeconomic status, ethnicity, and geographical region. Among 54,892,390 adults, obesity prevalence rose from 26.3% to 30.3%, with prevalence as high as 66.1% in the most-deprived Black women aged 60-69. Disparities were greatest among women, particularly Asian women in the most deprived quintile. Disparities widened since the COVID-19 pandemic, underscoring the preventable nature of obesity and the need to address dimensions of inequality in prevention efforts.
This retrospective longitudinal cohort study analyzed NHS England electronic health records on roughly 54.9 million adults from 2019 to 2025 to map how intersecting inequalities shape obesity. Overall obesity prevalence rose from 26.3% to 30.3%; prevalence ranged from 4.3% in least-deprived White men aged 18-19 to 66.1% in the most-deprived Black women aged 60-69. Steepest incidence increases occurred among adults aged 20-39, with widening socioeconomic, ethnic, and geographic disparities since the COVID-19 pandemic.
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